<extend name="Public:main" />

<block name="cssjs"></block>

<block name="area">
<li><a href="#">患者编辑</a></li>
</block>

<block name="content">
	<div class="formbody">
		<div class="formtitle"><span>患者编辑</span></div>
		<form action="__ACTION__" method="post" enctype="multipart/form-data" name="myform">
			<ul class="forminfo">
				<input type="hidden" name="id" value="{$list.id}" />
				<li><label>姓名:</label><input name="name" class="dfinput" type="text" value="{$list.name}"><i></i></li>
				<li><label>病种类别:</label><i></i>
					<select name="jid">
						<foreach name="category" item="vo">
							<option value="{$vo.id}" <if condition="$vo.id eq $list.jid">selected="selected"</if>>{$vo.title}</option>
						</foreach>
					</select>
				</li>
				<li><label>治疗类别:</label><i></i>
					<select name="tid">
						<foreach name="treat" item="vo">
							<option value="{$vo.id}" <if condition="$vo.id eq $list.tid">selected="selected"</if>>{$vo.title}</option>
						</foreach>
					</select>
				</li>
				<li><label>专项检查类别:</label><i></i>
					<select name="cid">
						<foreach name="check" item="vo">
							<option value="{$vo.id}" <if condition="$vo.id eq $list.cid">selected="selected"</if>>{$vo.title}</option>
						</foreach>
					</select>
				</li>
				<li><label>原图:</label><img src="{$list.pic}" style="width:100px;"><i></i></li>
				<li><label>图片:</label><input type="text" class="dfinput" id="titlepic" name='pic' />
					<input type="button" id="uploadbtn" value="选择图片" style="height:30px;width:80px;cursor:pointer;border-radius:2px;background-color:#DDD;" /><i>限jpg gif jpeg png 格式 200kb以内</i></li>
				<li><label>备注:</label><textarea id="pagecontent" name="remarks" rows="20" cols="100" style="width:65%;height:300px;visibility:hidden;">{$list.remarks}</textarea></li>
				<li><label>&nbsp;</label><input type="submit" class="btn" value="确认修改" /></li>
			</ul>
		</form>
	</div>
<script type="text/javascript">
$('.imgtable tbody tr:odd').addClass('odd');
</script>
</block>